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OPERATIVE REPORT Patient Name: Putul Barua Patient ID: 135799 Room No. : CCU-4 Date of Surgery: 01/08/2011 Admitting Physician: Simon Williams, MD, Pulmonology Surgeon: Simon Williams, MD, Pulmonology Preoperative Diagnosis: Recent onset hemoptysis, history of tuberculosis. Postoperative Diagnosis: No tuberculosis lesion seen. Name of Procedure: Bronchoscopy Specimens Removed: Blood clots. INDICATIONS: Mr. Barua requires Bronchoscopy, because of recent onset hemoptysis and a remote history of tuberculosis. PROCEDURE: The patient was routinely pre-medicated with 25mg of Demerol, with 2mg of Versed also used.

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About 4mL of 4% Xylocaine was used during the procedure. The glottis, epiglottis, pseudocords, and cords were normal. Upper trachea was normal. Lower trachea and carina were normal. A few small, scattered thrombi present were easily suctioned. The right upper lobe was observed. No endobronchial lesion was detected. The right lower lobe and right middle lobe were free of endobronchial lesions. The left side was entered, the left upper and lower lobe was investigated with no endobronchial lesions detected. We obtain no brushings, because of patients INR and the fact that he became hypoxic very quickly.

We had to do the procedure very quickly and discontinue it as soon as possible. No further significant hypoxia was observed. (Continued) OPERATIVE REPORT Patient Name: Putul Barua Patient ID: 135799 Date of Surgery: 01-08-2011 Page 2 The lowest level of hypoxia observed was about 86%, which was immediately reversed with an increase in oxygen therapy. DIAGNOSIS: Evidence of old hemorrhage. No new lesions seen. Recommend close follow up. ____________________________ Simon Williams, MD, Pulmonology SM:tc D:01/08/2011 T:01/08/2011

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